title: Dissociation between free and bound phenytoin levels in presence of valproate sodium.
abstract: A dissociation of free vs bound phenytoin levels is frequently observed in the presence of therapeutic doses of valproate sodium. This leads at times to symptoms and signs of phenytoin intoxication despite "therapeutic" plasma levels. The importance of supplementing bound levels with free levels is stressed when combined therapy of this type is used in epileptic patients.
mesh_terms: D000328:Adult; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D004831:Epilepsies, Myoclonic / Q000097:blood / Q000188:drug therapy; D005260:Female; D006801:Humans; D010672:Phenytoin / Q000032:analysis / Q000097:blood* / Q000627:therapeutic use; D012463:Saliva / Q000032:analysis*; D012640:Seizures / Q000097:blood / Q000188:drug therapy; D014635:Valproic Acid / Q000494:pharmacology* / Q000627:therapeutic use
chemical_list: D014635:Valproic Acid; D010672:Phenytoin